Are you able to perform the essential functions of the position without accommodations?

YesNo

If necessary for the job are you older than:

Are you legally eligible for employment in Belize?

under 13141821

YesNo

Are you seeking a Temporary or Permanent Position:

How many days after being hired would you be able to report to work?

TemporaryPermanent

If necessary for the job, are you able to work overtime?

Provide a valid Belize Driver's License?

YesNo

YesNo

If so, fill out the following:

License Class:

Issuing City/Town:

Which shifts are you willing to work?

BreakfastLunchDinnerRegular Office HoursAny/ All

EMPLOYMENT HISTORY

1.

Employer/Business Name:

Pay per week:

Position title/duties/skills:

Supervisor:

Telephone:

Start Date:

End Date:

Reason for Leaving:

2.

Employer/Business Name:

Pay per week:

Position title/duties/skills:

Supervisor:

Telephone:

Start Date:

End Date:

Reason for Leaving:

3.

Employer/Business Name:

Pay per week:

Position title/duties/skills:

Supervisor:

Telephone:

Start Date:

End Date:

Reason for Leaving:

EDUCATION

Institution Name

Years Completed

Field of Study

Graduate or Degree

High School

College/ University

Business/ Technical

Additional

SKILLS & QUALIFICATIONS

Other qualifications such as special skills, abilities or honors that should be considered:

Types of computers, software, and other equipment you are qualified to operate or repair:

Professional licenses, certifications or registrations:

Additional skills, including supervision skills, other languages or information regarding the career/occupation you wish to bring to the employer’s attention:

REFERENCES

List two personal references who are not relatives or former supervisors.

Name

Address

Telephone

Occupation

Years Known

1.

2.

CONTACT

In case of accident or illness, please contact:

Name

Address

Telephone

Relationship

INFORMATION TO THE APPLICANT

As part of our procedure for processing your employment application, your personal and employment references may be checked. If you have misrepresented or omitted any facts on this application, and are subsequently hired, you may be discharged from your job. If necessary for employment, you may be required to: supply your birth certificate or other proof of authorization to work in the Belize, have a drug test, or to sign a conflict of interest agreement and abide by its terms.

I understand and agree to the information shown above. Yes

Application Date:

By submitting the above application I agree to provide a Recent Police RecordYesNo